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提取和基于分子的婴儿早期致敏及相关因素-预防 ADALL 研究。

Extract and molecular-based early infant sensitization and associated factors-A PreventADALL study.

机构信息

Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Allergy. 2021 Sep;76(9):2730-2739. doi: 10.1111/all.14805. Epub 2021 May 4.

Abstract

BACKGROUND

More knowledge about sensitization patterns in early infancy, including impact of molecular allergology, is needed to help predict future allergy development more accurately.

OBJECTIVE

We aimed to determine the prevalence and patterns of allergic sensitization at 3 months of age, and explore possible associated factors.

METHODS

From the Scandinavian antenatally recruited PreventADALL mother-child cohort, we included 1110 3-month infants with available serum. Sensitization was defined as s-IgE of ≥0.1 kU /L by Phadiatop Infant (ThermoFisher Scientific) including birch, cat, grass, dog, milk, egg, peanut and wheat. Further ImmunoCAP analyses to ovomucoid, casein, Ara h 1-3, omega-5-gliadin were performed in food extract s-IgE-positive children. Maternal sensitization was defined as s-IgE ≥ 0.35 kU /L to Phadiatop (inhalant allergen mix) and/or Fx5 (food allergen mix) at 18-week pregnancy.

RESULTS

Overall 79 (7.3%) infants had specific sensitization, many with low s-IgE-levels (IQR 0.16-0.81 kU /L), with 78 being sensitized to food extract allergens; 41 to egg, 27 to milk, 10 to peanut, and 25 to wheat. A total of 62/78 were further analysed, 18 (29%) had s-IgE to ovomucoid, casein, Ara h 1-3 and/or omega-5-gliadin. Eight infants (0.7%) were sensitized to inhalant allergens. Maternal sensitization to food allergens was associated with infant sensitization, odds ratio 3.64 (95% CI 1.53-8.68).

CONCLUSION

Already at 3 months of age, 7% were sensitized to food, mostly without detectable s-IgE to food allergen molecules, and <1% to inhalant allergens. Maternal food sensitization was associated with infants' sensitization.

摘要

背景

为了更准确地预测未来的过敏发展,我们需要更多关于婴儿早期致敏模式的知识,包括分子过敏学的影响。

目的

我们旨在确定 3 个月龄时过敏致敏的患病率和模式,并探讨可能的相关因素。

方法

我们从斯堪的纳维亚前瞻性招募的预防 ADALL 母婴队列中,纳入了 1110 名 3 个月龄且有血清样本的婴儿。致敏定义为 Phadiatop Infant(赛默飞世尔科技)血清 s-IgE 水平≥0.1 kU/L,其中包括桦树、猫、草、狗、牛奶、鸡蛋、花生和小麦。在食物提取 s-IgE 阳性儿童中,进一步进行 ImmunoCAP 分析以检测卵白蛋白、酪蛋白、Ara h 1-3、ω-5-麦醇溶蛋白。母亲致敏定义为妊娠 18 周时 Phadiatop(吸入性过敏原混合物)和/或 Fx5(食物过敏原混合物)的 s-IgE≥0.35 kU/L。

结果

总体而言,79 名(7.3%)婴儿存在特异性致敏,许多婴儿的 s-IgE 水平较低(IQR 0.16-0.81 kU/L),其中 78 名婴儿对食物提取物过敏原致敏;41 名对鸡蛋、27 名对牛奶、10 名对花生、25 名对小麦。总共对 78 名中的 62 名进行了进一步分析,其中 18 名(29%)对卵白蛋白、酪蛋白、Ara h 1-3 和/或 ω-5-麦醇溶蛋白有 s-IgE。8 名婴儿(0.7%)对吸入性过敏原致敏。母亲对食物过敏原的致敏与婴儿的致敏有关,比值比为 3.64(95%CI 1.53-8.68)。

结论

即使在 3 个月大时,仍有 7%的婴儿对食物过敏,其中大多数婴儿对食物过敏原分子的 s-IgE 检测呈阴性,且对吸入性过敏原的致敏率<1%。母亲的食物致敏与婴儿的致敏有关。

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